Depression and bipolar disorder

Severe depression takes a huge toll on your everyday life. Many patients have tried numerous oral medications or electroconvulsive therapy with little to no relief.  According to the National Institute of Mental Health in a 2017 nationwide survey, 11 million Americans experienced depression with severe impairment and out of those, one-third experienced treatment resistant depression.  With depression often the synapses(junctions) of the brain are broken or weakened contributing to the symptoms.  Ketamine has been scientifically proven to strengthen and even regrow these synapses(synaptogenesis).  In autopsies of people who have died of suicide, doctors have found they had higher levels of glutamate in their brains.  N-methyl-D-asparate receptors (NMDA) are in the glutamate system and when the glutamate levels get too high the NMDA receptors are overstimulated leading to depression.  Ketamine is a NMDA antagonist which means it blocks glutamate.  It usually takes weeks to months to assess if a new oral medication may be effective.  With Ketamine, improved mood can happen as soon as the first infusion, but a typical response is usually noticed after multiple infusions and for some individuals a response is not noticeable until 2-3 weeks following the series of 6 infusions.  

Bipolar disorder (BD) is a psychiatric illness associated with high morbidity and mortality. It is neuroprogressive and has a high rate of treatment resistance. The treatment failure rates of bipolar depression are higher than those of major depressive disorder. It has the highest lifetime risk of suicide among all psychiatric disorders. Most patients with BD experience depression for a significant part of their lives. Hence, there is an unquestionable need for new BD treatment strategies. Ketamine appears to have rapid antidepressive and antisuicidal effects. Since most of the available studies concern unipolar depression, here we present a novel insight arguing that ketamine might be a promising treatment for bipolar disorder.

Depression and bipolar disorder